The difference is plain in the rhetoric different health care sectors use to describe the Republican bill.
Insurance companies praise provisions in the plan — a market stabilization fund, guaranteed payment of Obamacare subsidies, and an incentive for people to stay insured — that they say will improve the health insurance exchanges in the next few years.
“We are encouraged that the proposed Senate health reform legislation includes several urgently needed and important steps to help make the individual market for insurance more stable and affordable in 2018 and 2019,” the Blue Cross Blue Shield Association said in a statement.
The sentiment is widely shared within the industry.
“This bill does a lot of good things for immediate stability,” Kristine Grow, a spokesperson for America’s Health Insurance Plans, the top industry lobbying group, told me recently.
But the rest of the health care industry — particularly the “white coats,” physicians and hospitals — has outwardly opposed the bill. They say the $772 billion in Medicaid cuts and projected coverage losses would negatively affect Americans’ ability to access the health care they need (and those changes are also sure to affect their bottom lines).
When a collection of patient groups organized events opposing the bill in recent weeks, they were joined by both the American Hospital Association and the American Medical Association.
“We urge the Senate to go back to the drawing board and develop legislation that continues to provide coverage to all Americans who currently have it,” the hospitals association said in a statement.
The AMA charged that the Senate’s bill conflicted with the physician’s code to do no harm.
“The draft legislation violates that standard on many levels,” the association said.
Some insurers don’t like the Medicaid cuts either, as much of the program has been moved to managed care programs that are administered by private health insurers. Cuts to federal spending are sure to affect that business.
But in their assessment, the additional federal funding and tax cuts provided in the Republican plan seem to have come out as a wash for insurers. Even if many of them are declining to take a formal position on the bill, that is still more of an embrace than it’s seeing from most other parts of the industry.
“If you look at this bill, it’s not about one part of the market. It’s about the individual market. It’s about the Medicaid market,” Grow said, noting “how interrelated those two markets are. Many individuals ebb and flow between these two markets.”